Doppler Sonographic Evaluation of Cerebral Blood Flow in Anemia Resulting From Chronic Renal Failure

Abstract

Objective. This study was undertaken to describe Doppler sonographic measurement of cerebral blood flow in anemia secondary to chronic renal failure and to compare the results with data gathered from healthy control subjects. We also aimed to compare vertebral and internal carotid artery blood flows to see whether any alteration of dominance in cerebral blood supply would occur. Methods. We studied 27 predialytic patients with chronic anemia resulting from chronic renal failure and 20 healthy control subjects by means of extracranial Doppler sonography. In these patients, blood flows of bilateral internal carotid and vertebral arteries were measured, and net vertebral artery, net internal carotid artery, and total cerebral blood flows were estimated. Statistical significance was observed between groups, and the data were correlated with hemoglobin level. Variation of the difference of the Doppler measurements between case and control groups by side (left or right) or disease status (patient or control subject) was analyzed. Results. From the assessed Doppler parameters, only cerebral blood flow and right and net vertebral artery blood flows had a significant difference between groups (P < .05) and showed a negative correlation with hemoglobin level. Vertebral artery blood flow was found to have significant interactions with disease status (P = .009) and side (P = .054). Conclusions. Right vertebral artery blood flow is most prone to increase in chronic anemia of chronic renal failure. This effect also appears as increasing net vertebral artery blood flow and cerebral blood flow.

Anemia rather than hypertension contributes to cerebral hyperperfusion in young adults undergoing hemodialysis: A phase contrast MRI study

“…Bilateral VAs increased flow velocities and kept arterial areas unchanged to support elevated blood flow. Our findings about elevated velocities of VAs were consistent with one previous study based on Doppler sonography 10 . However, the cross-sectional areas of VAs were not significantly changed in our study, which was not consistent with theirs 10 .…”

“…Our findings about elevated velocities of VAs were consistent with one previous study based on Doppler sonography 10 . However, the cross-sectional areas of VAs were not significantly changed in our study, which was not consistent with theirs 10 . Our patients were much younger and had much higher blood pressure than theirs.…”

“…Increased CBF in CKD patients has been repeatedly reported by multimodality imaging studies, such as 133 Xe inhalation technique 3 , 15 O positron emission tomography 4 5 , arterial spin labeling MRI 6 and Doppler ultrasonography 10 . Our findings based on pcMRI were consistent with previous studies 3 4 5 6 10 , supporting that pcMRI technique could provide reliable results. Specially, the measured blood velocity and blood flow were not sensitive to T1 or T2 of the spins because pcMRI utilizes the phase of an image to encode the velocity of moving spins.…”

Extracranial carotid Doppler ultrasound evaluation of cerebral blood flow volume in COPD patients

“…In that study, particu-larly, VA lumen was increased in anemic patients. 37 In a study with chronic hypercapnic COPD patients, oxygen replacement treatment was shown to decrease CBF velocity, detected with transcranial Doppler ultrasound. 5 Doppler ultrasound of extracranial carotid and VA is a well-established method to assess cerebrovascular circulation.…”

Carotid hemodynamic parameters in hemodialysis patients

“…Haktanir et al [28] showed that luminal diameter of vertebral artery (VA) increased in patients with anemia related to chronic renal failure. Chronic anemia causes hypoxia decreasing oxygen transport capacity of blood, and hypoxia causes certain changes in vascular system directed to increase of blood oxygenation.…”